5 research outputs found
Follow-up after radiological intervention in oncology: ECIO-ESOI evidence and consensus-based recommendations for clinical practice
Interventional radiology plays an important and increasing role in cancer treatment. Follow-up is important to be able
to assess treatment success and detect locoregional and distant recurrence and recommendations for follow-up are
needed. At ECIO 2018, a joint ECIO-ESOI session was organized to establish follow-up recommendations for oncologic
intervention in liver, renal, and lung cancer. Treatments included thermal ablation, TACE, and TARE. In total five topics
were evaluated: ablation in colorectal liver metastases (CRLM), TARE in CRLM, TACE and TARE in HCC, ablation in renal
cancer, and ablation in lung cancer. Evaluated modalities were FDG-PET-CT, CT, MRI, and (contrast-enhanced)
ultrasound. Prior to the session, five experts were selected and performed a systematic review and presented
statements, which were voted on in a telephone conference prior to the meeting by all panelists. These statements
were presented and discussed at the ECIO-ESOI session at ECIO 2018. This paper presents the recommendations that
followed from these initiatives. Based on expert opinions and the available evidence, follow-up schedules were
proposed for liver cancer, renal cancer, and lung cancer. FDG-PET-CT, CT, and MRI are the recommended modalities,
but one should beware of false-positive signs of residual tumor or recurrence due to inflammation early after the
intervention. There is a need for prospective preferably multicenter studies to validate new techniques and new
response criteria. This paper presents recommendations that can be used in clinical practice to perform the follow-up
of patients with liver, lung, and renal cancer who were treated with interventional locoregional therapies
Follow-up after radiological intervention in oncology: ECIO-ESOI evidence and consensus-based recommendations for clinical practice
Interventional radiology plays an important and increasing role in cancer treatment. Follow-up is important to be able
to assess treatment success and detect locoregional and distant recurrence and recommendations for follow-up are
needed. At ECIO 2018, a joint ECIO-ESOI session was organized to establish follow-up recommendations for oncologic
intervention in liver, renal, and lung cancer. Treatments included thermal ablation, TACE, and TARE. In total five topics
were evaluated: ablation in colorectal liver metastases (CRLM), TARE in CRLM, TACE and TARE in HCC, ablation in renal
cancer, and ablation in lung cancer. Evaluated modalities were FDG-PET-CT, CT, MRI, and (contrast-enhanced)
ultrasound. Prior to the session, five experts were selected and performed a systematic review and presented
statements, which were voted on in a telephone conference prior to the meeting by all panelists. These statements
were presented and discussed at the ECIO-ESOI session at ECIO 2018. This paper presents the recommendations that
followed from these initiatives. Based on expert opinions and the available evidence, follow-up schedules were
proposed for liver cancer, renal cancer, and lung cancer. FDG-PET-CT, CT, and MRI are the recommended modalities,
but one should beware of false-positive signs of residual tumor or recurrence due to inflammation early after the
intervention. There is a need for prospective preferably multicenter studies to validate new techniques and new
response criteria. This paper presents recommendations that can be used in clinical practice to perform the follow-up
of patients with liver, lung, and renal cancer who were treated with interventional locoregional therapies
Transarterial Radioembolization for the Treatment of Advanced Hepatocellular Carcinoma Invading the Right Atrium
Clinical impact of (18)F-choline PET/CT in patients with recurrent prostate cancer
PURPOSE: To investigate the clinical value of (18)F-fluorocholine PET/CT (CH-PET/CT) in treatment decisions in patients with recurrent prostate cancer (rPCA).
METHODS: The study was a retrospective evaluation of 156 patients with rPCA and CH-PET/CT for restaging. Questionnaires for each examination were sent to the referring physicians 14-64 months after examination. Questions included information regarding initial extent of disease, curative first-line treatment, and the treatment plan before and after CH-PET/CT. Additionally, PSA values at diagnosis, after initial treatment, before CH-PET/CT and at the end of follow-up were also obtained from the questionnaires.
RESULTS: Mean follow-up was 42 months. The mean Gleason score was 6.9 at initial diagnosis. Initial treatment was: radical prostatectomy in 110 patients, radiotherapy in 39, and combined prostatectomy and radiotherapy in 7. Median PSA values before CH-PET/CT and at the end of follow-up were 3.40 ng/ml and 0.91 ng/ml. PSA levels remained stable, decreased or were below measurable levels in 108 patients. PSA levels increased in 48 patients. In 75 of the 156 patients (48%) the treatment plan was changed due to the CH-PET/CT findings. In 33 patients the therapeutic plan was changed from palliative treatment to treatment with curative intent. In 15 patients treatment was changed from curative to palliative. In 8 patients treatment was changed from curative to another strategy and in 2 patients from one palliative strategy to another. In 17 patients the treatment plan was adapted.
CONCLUSION: CH-PET/CT has an important impact on the therapeutic strategy in patients with rPCA and can help to determine an appropriate treatment
Perfusion CT best predicts outcome after radioembolization of liver metastases: a comparison of radionuclide and CT imaging techniques
OBJECTIVE: To determine the best predictor for the response to and survival with transarterial radioembolisation (RE) with (90)yttrium microspheres in patients with liver metastases.
METHODS: Forty consecutive patients with liver metastases undergoing RE were evaluated with multiphase CT, perfusion CT and (99m)Tc-MAA SPECT. Arterial perfusion (AP) from perfusion CT, HU values from the arterial (aHU) and portal venous phase (pvHU) CT, and (99m)Tc-MAA uptake ratio of metastases were determined. Morphologic response was evaluated after 4Â months and available in 30 patients. One-year survival was calculated with Kaplan-Meier curves.
RESULTS: We found significant differences between responders and non-responders for AP (P 20 ml/100 ml/min had a significantly (P = 0.01) higher 1-year survival, whereas an aHU value >55 HU did not discriminate survival (P = 0.12). The Cox proportional hazard model revealed AP as the only significant (P = 0.02) independent predictor of survival.
CONCLUSION: Compared to arterial and portal venous enhancement and the (99m)Tc-MAA uptake ratio of liver metastases, the AP from perfusion CT is the best predictor of morphologic response to and 1-year survival with RE.
KEY POINTS: • Perfusion CT allows for calculation of the liver arterial perfusion. • Arterial perfusion of liver metastases differs between responders and non-responders to RE. • Arterial perfusion can be used to select patients responding to RE